Before & After Rhinoplasty Surgery

When patients undergo a rhinoplasty procedure in Charlotte, I believe it is important for patients to have a clear idea of what to expect before and after the operation, as well as ways to ensure that everything goes smoothly.  Every patient heals differently, so  I make sure to take the time to discuss any concerns or questions a patient may about any step in the process to help minimize or eliminate anxiety. It is important that each and every patient feels comfortable and confident before and after a rhinoplasty.

TWO WEEKS PRIOR / FOLLOWING SURGERY:

1. Avoid all products that may interfere with blood clotting. Examples: aspirin, ibuprofen, or aspirin based products, NSAIDS (non-steroid anti-inflammatory drugs), vitamins E, fish oil, and supplements, garlic extract, alcohol (including wine and beer), herbal products and fish.
2. Avoid all smoking or nicotine products including nicotine gum and patch.
3. Avoid all medications unless cleared through our office.  Contact prescribing doctor for alternative medication if necessary. You must notify us of ANY medications you are taking. This includes over the counter, non-prescription drugs.
4. Tylenol (acetaminophen) is allowed pre-op and post-op for pain and/or fever.
5. Purchase: hydrogen peroxide, Q-tips, baby shampoo, Arnica, Bromelain, Bacitracin Ointment, and distilled water.
6. Discontinue all diet pills or supplements 2 weeks prior to surgery.
7. For nasal surgery, one should trim one’s nasal hairs prior to surgery.

DAY/NIGHT BEFORE SURGERY

1. Wash face and shampoo hair using baby shampoo and gentle soap.
2. Do not eat or drink anything after midnight except as directed by doctor or staff.
3. Fill and pick up all post-op prescriptions.
4. All travel companion arrangements are in order for transportation to the surgery and pick up after. This companion should remain with you for several hours following surgery. You will not be allowed to proceed with surgery unless these arrangements are in order.

DAY OF SURGERY

1. Take any pre-op medication as instructed by doctor or staff, only if pre-approved.
2. Remove contact lenses.
3. Leave valuables at home or with family members.
4. Bring a form of ID and manner in which to pay for surgery center, if applicable.
5. Wear loose comfortable clothing. Bring warm socks, as it may be cool in the surgery suite (No glasses after a rhinoplasty).
6. Do not sign any papers, make appointments or important decisions for 24 hours after surgery. The post-op medications may alter your judgment.

WHAT TO EXPECT FOLLOWING NASAL SURGERY

Certain physical changes are expected following nasal surgery.  Some individuals experience all of the following and others only some.  The degree to which each person is affected is variable and unpredictable.  You may experience changes that are not included in this list.

BLEEDING – Bloody drainage is common in the first 48 hours after surgery.  Blood-tinged nasal discharge may persist for 1-2 weeks following surgery.  Profuse bleeding is unusual.  Should this occur, pinch your nostrils together firmly for 10 minutes without interruptions.  If this does not stop the bleeding, call our office immediately.

SWELLING – Nasal swelling is expected and may not be readily noticeable until after the splint is removed.  Most of the swelling subsides in 4-6 weeks, but subtle swelling may persist for 6-12 months. In certain situations, the doctor may inject a small amount of medicine into your nose to help reduce the swelling.

BRUISING – Bruises following nasal surgery usually manifests as “black eyes”.  Most bruising will resolve in 2-3 weeks and may be concealed with makeup if desired.

BREATHING – Nasal breathing may be difficult for 2-3 weeks after surgery due to swelling inside the nose.  This “stuffiness” will subside gradually and IS NOT improved with nasal sprays. Decongestive nasal sprays may actually cause damage to the nose and impair healing.

DISCHARGE – As noted above, blood-tinged nasal discharge is common following surgery and may persists for 1-2 weeks.

ITCHING/NUMBNESS – Itching, numbness and a “wooden feeling” to the nose are common.  All of these do subside, although, it may take months for your nose to feel completely “normal”.

CARE AFTER NASAL SURGERY

• Clean the incision line and nostril rim at the base of the nose once a day with ½ strength hydrogen peroxide.  Mix with distilled water.
• Drip pad may be discontinued when no longer needed, 1-3 days.
• Apply antibiotic ointments, Bacitracin (which can be purchased at the drug store) to nostrils and incisions twice daily.
• All stitches will be removed in approximately 7 days.
• A humidifier is recommended; you may shower after your first post-op, if you cover your cast with a piece of plastic as a shield.
• Ice cubes in rubber gloves, cold compresses or frozen peas should be used for 72 hours or an hourly basis when awake. Then after, use warm compress in areas of bruising.
• No heavy exercise for 2 weeks.
• No sunglasses/eyeglasses for 6 weeks after surgery.
• Keep head elevated while resting, relaxing, or sleeping for at least 1-2 weeks.
• Do not blow your nose or sniff excessively as this will only irritate the healing tissues.  If you must sneeze, open your mouth.

POST-OPERATIVE DIET SUGGESTIONS

• DRINK PLENTY OF LIQUIDS: Please drink as much water as possible, in addition to other liquids. Avoid sodas and caffeinated drinks. Citrus-based juices may irritate your stomach.
• Good nutritious food on the first 2-3 days are very important  in the healing process and will help you feel stronger sooner. Soft foods are best to start out with. Here are some suggestions: baked or mashed potatoes, warm soups, creamed vegetables, canned fruit, oatmeal, Cream of Wheat, any type of baby food, yogurt, bananas, apple sauce, JELLO, pudding.  Fruit Smoothie: Mix 3-4 Tbsp yogurt, with one cup juice, and any fruit. Blend until smooth.
• NO SMOKING
• NO ALCOHOL
• NO diet foods. NO diet drinks. Your body needs the calories for proper healing.
• NO aspirin or aspirin based products (see attached list).
• No salty or spicy foods.
• No hot temperature foods (warm is preferred) as it may cause bleeding.
• No heavy or big meals. Start small and light, then slowly increase as tolerated.

SUGGESTIONS TO MINIMIZE SWELLING AND BRUISING

Arnika Forte can be purchased at our office to prevent bruising (take as instructed).

If you must take something for relief of headache, menstrual cramps, backache, etc., please take TYLENOL (as directed) for the two weeks before and after your surgery.

PLEASE CHECK ALL MEDICATIONS YOU ARE TAKING FOR ASPIRIN CONTENT. If you are taking a medication not listed above you may call the office to check the Aspirin/Ibuprofen content of you can contact your pharmacist.

All herbal medicines, vitamins and dietary/nutritional supplements need to be stopped two weeks prior to surgery by weaning over three days.

Sleep on your back with your head elevated with 2 or 3 pillows

Do not wear glasses for 6 weeks.  If glasses must be worn, they must be taped to your forehead.

No exercise the first week.  Straining or lifting can cause bleeding.  Physical activity should be slowly increase over 1 month.  Full activity can be resumed at that time.

Pain medications can cause constipation.  We recommend taking a stool softener while taking narcotic pain medications.

Antibiotics can cause abdominal discomfort.  We recommend taking probiotics while on antibiotics.

ASPIRIN  CONTAINING COMPOUNDS & MEDICATIONS

***IMPORTANT INSTRUCTIONS***

Aspirin and aspirin-related drugs (including arthritis and cold medications) cause prolonged and excessive bleeding in normal individuals during surgery. Therefore, you must not take these products for two weeks before and after your surgery.

The following is a partial list of medications containing Aspirin that are to be avoided:

A.P.C., Advil, Alka-Seltzer, Anacin, Anaprox, Arthritis Pain Formula, Ascodeen-30, Ascriptin, Aspirin Suppositories (all brands), Aspirin

Bayer Aspirin, Buff-a-Comp, Buffadyne, Bufferin, Butalbital

Carna Arthritis Pain Reliever, Carna-Inlay Tabs, Cheracol Capsules, Congespirin, Cope Coricidin, Coricidin

Darvon Compound, Dristan, Doans Pills, Duragesic

Ecotrin, Empirin, Emprazil, Equagesic, Excedrin

Fiorinol, Four-Way Cold Tablets

Indocin

Measurin, Midol, Monacet with Codeine, Motrin

Naprosyn, Norgesic, Nuprin

Os-Cal-Gone

Pamprin, Pamprin (Buffered), Panalgesic, Pepto-Bismol, Percodan, Persistin, Propoxyphene

Robaxisal

Sine-Off, Stendin, Stero-Darvon with A.S.A., Supac, Synalgos, Synalgos-DC,

Tolectin, Traminicin

Vanquish, Voltaren

Contact Carolina Facial Plastics

As an expert rhinoplasty in Charlotte, I take every precaution to ensure that my patients have the smoothest and fastest recovery period possible. I am available to discuss any concerns or questions with my patients at all times during the recovery process, as well. To schedule a consultation to learn more about a rhinoplasty, please call us at (704) 842-3644 or fill out the online contact form.

Next, read about Nasal Obstruction Surgery